839NO. STREET j LOT NO.
" AP��. q �1R ELECTRICAL PERMIT '
CI F CUPERTINO
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Date `` 2�5� �"� Permit No.
r1. ,1 Of C Fee $
Application is hereby made to the City of Cupertino for a permit to install electrical
-wiring and/or fixtures as listed on the reverse side hereof, and agrees to install said
wiring and/or fixtures in accordance with the provisions of the Electrical Code of the
City of Cupertino, and all other laws applicable thereto.
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;j Owner
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By.
h CONTRACTOR, AGENT
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